QUALITY OF LIFE IN CHILDREN WITH OBSTRUCTIVE SLEEP APNEA AFTER ADENOIDECTOMY

Introduction: Sleep-disordered breathing is common in children.There is a large scale of symptoms, from plain harmless snoring to obstructive sleep apnea syndrome (OSAS). Obstructive sleep apnea in pediatric population is commonly caused by enlarged tonsils or adenoids and affects between 1% and 3% preschool and school aged population. The aim of this study was to examine quality of life in children before and after adenoidectomy, that did not have enlarged tonsils. Patients and Methods: Prospective study included 30 children with OSA symptoms both sexes from 3-12 years old consequtive admited to ENT Clinic Tuzla for adenoidectomy, without tonsillar hypertrophy,and it was carried out in the period from mid November 2005 to end of June 2006. Specific exclusion criteria were: no existing of OSA, neuromuscular disorders, constitutional maxillofacial anomalys, septal deviation, mental retardation, obesity (BMI>30). Hystory was taken from parents or caregiver, each child was examined from ENT specialist, paediatrician and anestesiologist. The adenoid size was estimated by palpation or/and X-ray examination of nasopharynx. By oropharyngoscopy was not found tonsillar hypertrophy. OSA -18 quality of life survey was used to estimate improvement of quality of life after adenoidectomy. The same parent completed OSA-18 servey before surgery and second OSA-18 servey 5 weeks after surgery. The children, that had asserted symptoms of OSA by OSA-18 quality life survey, were analysed by this survey 5 weeks after surgery.Results before and after surgery were compared. Adenoidectomy was done with standard operation technik at ENT departmant, witch includes complete removal of adenoids with uniform anestesiology protocol. Results: In 13 patients undergone adenoidectomy OSA had a small impact on quolity of life, at 13 patents had a moderate impact and at 4 patents had a large impact. Significant improovement of quality of life after adenoidectomy was found in all domains using QOL-OSA-18 test: sleep disturbance (P< .0001), physical suffering (P< .0001), emotional distress (P< .0001), daytime problems (P= .0055) and caregiver concerns (P< .0001). The mean OSA-18 –QOL total change score showed significant impruvment of quality of life in patients suffering from OSA who undergone adenoidectomy (P< .0001).